Nursing considerations
Assessment
• History: Hypersensitivity to atomoxetine or constituents of Strattera; use of MAOIs within the past 14 days; narrow-angle glaucoma, hypertension, tachycardia, CV or cerebrovascular disease, pregnancy, lactation
• Physical: Height, weight, T; skin color, lesions; orientation, affect; P, BP, auscultation; R, adventitious sounds; bowel sounds, normal output
Interventions
• Ensure proper diagnosis before administering to children for behavioral syndromes: drug should not be used until other causes and concomitants of abnormal behavior (learning disability, EEG abnormalities, neurological deficits) are ruled out.
• Ensure that drug is being used as part of an overall treatment program including education and psychosocial interventions.
• Arrange to interrupt drug dosage periodically in children being treated for behavioral disorders to determine if symptoms recur at an intensity that warrants continued drug therapy.
• Monitor growth of children on long-term atomoxetine therapy.
• Administer drug before 6 PM to prevent insomnia if that is a problem.
• Monitor BP early in treatment, particularly with adult patients.
• Arrange for consult with school nurse of school-age patients receiving this drug.
• For women of childbearing age who are using this drug, suggest using contraceptives.
Teaching points
• Take this drug exactly as prescribed. It can be taken once a day in the morning, if adverse effects are a problem, the drug can be taken in two evenly divided doses in the morning and in the late afternoon or early evening.
• Take drug before 6 PM to avoid night-time sleep disturbance.
• Avoid the use of alcohol and OTC drugs, including nose drops, cold remedies, and herbal therapies while taking this drug; some of these products cause dangerous effects. If you feel that you need one of these preparations, consult your health care provider.
• The effects of this drug on the unborn baby are not known. Women of childbearing age are advised to use contraceptives.
• You may experience these side effects: Dizziness, insomnia, moodiness (these effects may become less pronounced after a few days; avoid driving a car or engaging in activities that require alertness if these occur; notify your health care provider if these are pronounced or bothersome); headache (analgesics may be available to help), loss of appetite, dry mouth (eat frequent small meals and suck on sugarless lozenges).
• Report palpitations, dizziness, weight loss, severe dry mouth and difficulty swallowing, pregnancy.